ABC - Health News

Narvikk/iStockBy DR. YALDA SAFAI, ABC News

(NEW YORK) -- People with substance use disorders may be more likely to become infected and die of COVID-19, according to a recent study funded by the National Institutes of Health and published in Molecular Psychiatry.

Specifically, the study found that people with opioid use disorder and tobacco addiction were more likely to die of COVID-19.

"Drugs inhibit the ability to fight viral and bacterial infections, disrupting immune function," Dr. Nora D. Volkow, director of the National Institute on Drug Abuse and co-author of the study, told ABC News.

"Opioids inhibit the respiratory centers in the brain. The combination of the two leads to the increased risk of COVID and its complications," she added.

Opioid epidemic meets the coronavirus


The opioid epidemic that began in the 1990s is now a global health crisis, and with the rise of the coronavirus pandemic, the two public health crises are now colliding in the United States.

The Centers for Disease Control and Prevention estimated that more than 70,000 people died in the U.S. from an opioid overdose in 2019. These numbers are projected to be higher in 2020.

Overdose with opioids is caused by the respiratory depressant effects of these drugs. Opioids -- including but not limited to heroin, oxycodone, hydrocodone and fentanyl -- work by slowing down the breathing rate.

COVID-19 also affects breathing, decreasing the ability to properly take in oxygen, which makes the combination of opioids and COVID-19 infection particularly lethal.

Tobacco and cocaine increase risks too


In addition, the chronic use of drugs such as tobacco, cocaine and opioids is associated with heart problems, including risk for heart attacks and heart failure.

"Cocaine doesn't work in the same way opioids do. Stimulants, such as cocaine, work by causing constriction of blood vessels," said Volkow. Chronic cocaine use can lead to high blood pressure, which is also a risk factor for COVID-19 complications.

"All substance use is highly comorbid with tobacco use," which can leave you more vulnerable to respiratory illnesses, added Volkow.

The U.S. Food and Drug Administration warns that smoking cigarettes can cause heart and lung disease and people with underlying heart and lung problems may have increased risk for serious complications from COVID-19.

"Smoking can also cause inflammation and cell damage in the body, and can weaken your immune system, making it less able to fight off disease," they add.

The pandemic has led to an increase in many risk factors for substance addiction, including isolation, financial hardship and mental health problems. The need for treatment services has gone up significantly while mental health and addiction treatment centers have struggled to stay open. Financial burdens caused by safety regulations, quarantine rules, limited capacity and fewer physician referrals are only some of the reasons these centers have been having a hard time staying afloat.

Disruptions in treatment caused by the pandemic


The CDC noted on its website that the COVID-19 pandemic has caused disruptions in treatment.

In-person treatment options might not be available, which may bring on a relapse for those in remission. Narcotics Anonymous meetings, for instance, were suspended early in the pandemic, just when support was perhaps needed most, and the transition to online meetings was slow. Now they're beginning to open up, offering social support and mentorship that are often fundamental to recovery.

Syringe service programs may be closed or have reduced hours, limiting access to clean syringes, constituting a public health hazard. Illicit drug supplies might be limited, or access disrupted due to social distancing, which can potentially lead to the risk of using contaminated drug products that might increase overdoses or other adverse reactions.

In addition, social distancing rules and stay-at-home mandates may lead to higher numbers of people using substances alone, without others around to administer life saving remedies such as naloxone or to call for help in the case of overdose.

"It is very important for substance users to recognize that they are at a higher risk," said Volkow.

The study emphasizes the need to screen for, and treat, substance use as part of the plan for controlling the pandemic.

It is important for health care providers to closely monitor patients with substance use and develop a plan to help protect them from infection and severe outcomes, the study concludes.

Find a health care provider or treatment for substance use disorder and mental health: SAMHSA's National Helplineexternal icon: 1-800-662-HELP (4357) and TTY 1-800-487-4889

Yalda Safai, M.D., M.P.H., is a psychiatry resident in New York City and contributor to ABC News' Medical Unit.

Copyright © 2020, ABC Audio. All rights reserved.



narvikk/iStockBy DR. LEAH CROLL, ABC News

(NEW YORK) -- More than 90% of U.S. adults remain susceptible to COVID-19, according to research published on Friday.

Using data from dialysis centers in the United States, the study, published in The Lancet, estimates that less than 10% of U.S. adults have virus antibodies, meaning everyone else is potentially vulnerable to infection.

Those figures roughly match those of a forthcoming Centers of Disease Control and Prevention study, according to CDC Director Dr. Robert Redfield, who spoke at a Senate hearing on Wednesday.

"The preliminary results in the first round show that a majority of our nation, more than 90% of the population, remains susceptible," said Redfield, referring to an ongoing CDC study assessing the prevalence of antibodies to better track how widely the virus has spread.

CDC data from that study is expected to be published in the "next week or so," Redfield added.

The Lancet study offers new details about the prevalence of COVID-19. Researchers at Stanford University studied 28,503 U.S. patients receiving dialysis in July 2020 and found that 8% of those sampled had COVID-19 antibodies -- 9.3% when standardized to the general U.S. adult population.

The study raises questions over "herd immunity," the idea that when enough a large enough population becomes immune the virus could die off. One big problem, experts have said, is that they don't yet know enough about how immunity to COVID-19 develops to say whether antibodies provide adequate protection from reinfection.

"What we know about antibodies is that things get a little dicey," said Dr. Jay Bhatt, an ABC News contributor and former chief medical officer of the American Hospital Association. "People don't have a uniformly consistent or strong antibody response, so the question is, 'Can we achieve herd immunity with this particular virus, or will that not be possible?'"

The results provide "yet another data point that helps us reinforce that there are significant amounts of people in this country that haven't been exposed to the virus," Bhatt added. "This study suggests that we have a long way to go to get to the kind of immunity we need to move past the virus."

This study is different from many others in that it looked at dialysis patients, who already undergo routine, monthly laboratory studies. This allows for better and more reliable data collection.

Dialysis cleans the blood of patients with end-stage kidney disease. Because dialysis patients are from a diverse range of backgrounds, ethnicities and socioeconomic statuses, the group studied is a reasonable approximation for the rest of the country, the researchers said.

John Brownstein, an ABC News contributor and epidemiologist at Boston Children's Hospital, said the study's findings should be taken with a grain of salt as dialysis patients aren't necessarily representative of the general population.

Because dialysis patients are less likely to be employed and many have issues with mobility, they also could have been exposed to COVID-19 at lower rates, which would mean the actual number of people with antibodies has been underestimated. Or conversely, individuals on dialysis may be more susceptible to the virus because of chronic underlying health issues, meaning the number of those with antibodies has been overestimated.

Patients with end-stage kidney disease and patients with severe COVID-19 have several risk factors in common: they're older, have higher rates of hypertension and diabetes, and people of color are disproportionately affected by both. This adds an extra layer of insight to the study's findings.

"Being able to understand the level of vulnerability of the part of the population that is going to be most impacted by the virus is important," Brownstein said. "And understanding where they are at in terms of immunity or potential immunity is valuable information."

Leah Croll, M.D., a neurology resident at NYU Langone Health, is a contributor to the ABC News Medical Unit.

Copyright © 2020, ABC Audio. All rights reserved.



Elen11/iStockBy ERIC MOLLO, ABC News

(NEW YORK) – Retired colonel Terry Virts has spent over seven months in space, serving as a NASA astronaut, performing space walks, and commanding the International Space Station.

The former U.S. Air Force pilot spoke to ABC News this week about his new book, How to Astronaut: An Insider's Guide to Leaving Planet Earth, in which he details things like taking a shower in space, eating, sleeping, and what happens if an astronaut gets stranded.

On ABC News’ “Perspective” podcast, Virts told ABC’s Cheri Preston he dealt with a lot of isolation while traveling in space:

"We had a couple of cargo ships blow up and I was stuck in space. We didn't know when we were coming back. We were low on supplies. So it's really similar to what we're doing down here now… There is a chapter about how to survive isolation."

As a former fighter pilot and astronaut, Virts says he frequently had to confront the possibility that he could die instantly. By compartmentalizing the grim prospect of instant death, he was actually able to carry out his duties:

"If you thought about that for 200 days, you know, you'd go insane… You just have to figure out how to put it in a different compartment in your brain so it's not in the front."

Virts believes the isolation he experienced in space mirrors much of what people have had to manage amid the COVID-19 pandemic. One way he dealt with isolation and continues to do so today is by keeping a positive attitude and reminding himself that negative experiences will not last forever. Other tips that have helped him through isolation include getting physical exercise and taking on an art project:

“When I was in space, I took pictures and I helped film a movie, “A Beautiful Planet,” which is really helping me now because I'm kind of moving into the TV and film universe. So, I think if you can write a book or learn photography or start painting or whatever, doing something artistic I think is really good for the human brain.”

Retired astronaut Clayton Anderson previously appeared on "Perspective," during which he admitted that one of the biggest challenges he faced while traveling through space was spending time with people he did not particularly like. Virts believes that experience is relatable both for astronauts and those who are self-isolating, and that it is something people should think about critically as the pandemic continues:

"That is super important. Look, you're not going to like everybody in life... even if you're married to someone that you love, if you're spending 24/7 for 200 days with them, that's going to get old after a while... It's [space traveling] the ultimate isolation: being stuck in a can with a few other people. Many of them are not even from your country… don't speak your language... Give yourself some personal space and some personal time. The technical aspects of spaceflight are hard and can kill you. But it's the psychological aspect that's even harder--the interpersonal relationships--because that is the ultimate quarantine."

Listen to the rest of this past week’s highlights from Perspective here.
 
Copyright © 2020, ABC Audio. All rights reserved.



fizkes/iStockBy JENNI GOLDSTEIN, ABC News

(NEW YORK) -- September is National Recovery Month. Every September for the last 31 years, organizations across the country use this month to educate Americans about substance use disorders, mental health treatment and service options available to help in the recovery process. Patty McCarthy is the CEO of Faces & Voices of Recovery, an organization with the goal of organizing and mobilizing Americans to achieve long-term recovery through its advocacy efforts.

McCarthy herself has been in long term recovery for over thirty years. Each year marks a new theme for the month. The 2020 theme is Join The Voices for Recovery, Celebrating Connections.

McCarthy told the ABC News "Perspective" podcast:

 “We know that we can't do it alone. So that's why the theme of celebrating connections is so important, especially right now during COVID-19, when connecting with people has become a whole new challenge when we're not able to visit with people in person or attend our usual gatherings to support recovery.”

Listen to the full interview with Patty McCarthy here.

Martine Hackett is an associate professor in the Master of Public Health and Community Health Programs at Hofstra University. Hackett told the "Perspective" podcast that racial disparities can make it more difficult for minorities to get the help they need to recover from substance misuse.

“Some of these barriers that minorities face when it comes to identifying help have to do with even their perceived need for treatment,” said Hackett.

Hackett said it is important to recognize that they might not want to have help from official means and might be more comfortable receiving that assistance from family, friends or religious organizations instead.

Hackett says trauma and racial tensions also play a role in how alcohol and drug can be used as a coping mechanism:

“Concepts around trauma and the experiences of trauma, particularly at an early age, might make people more susceptible to addiction. There’s research that talks about the stressors of racism and how those stressors can cause behaviors that people reach to be able to deal with those stressors.”

Another challenge that minorities might face is access to behavioral health services. Hackett said Native Americans are particularly afflicted by substance misuse.  

“They [Native Americans] have a higher rate of addiction, but they also have a lower rate of recovery and being able to seek recovery,” said Hackett.

McCarthy said that recognizing the language and terminology we use when referring to those in recovery is an important step not only to help with the process, but to humanize their struggles:

“We no longer use words like addict. We no longer use the word drug abuse. We have to remember that these are our family, friends, sons and daughters. We have shifted to person-first language, such as a person with a substance use disorder.”

The stigma that many associate with those in recovery can make it more difficult for many to seek help. This is especially true for minority communities.

“There are certain ways that different cultures view addiction,” said Hackett. “People might not feel comfortable being able to even admit that they have a problem.”

Resources are available at Faces & Voices of Recovery's website for National Recovery Month and beyond. More information about how the month is celebrated can be found at nationalrecoverymonth.org.

“Recovery is a journey,” said McCarthy. “We want a path to a better future.”

Copyright © 2020, ABC Audio. All rights reserved.



evemilla/iStockBy CATHERINE THORBECKE, ABC News

(NEW YORK) -- Health officials have issued a new warning against abusing the allergy medicine Benadryl after reports emerged of a so-called "Benadryl challenge" gaining popularity on the app TikTok.

Reminiscent of the deadly "Tide Pod Challenge," the latest dangerous social media trend is encouraging young people to take higher-than-recommended doses of the over-the-counter drug whose generic name is diphenhydramine.

The U.S. Food and Drug Administration warned in a statement Thursday that this can lead to "serious heart problems, seizures, coma or even death."

"We are aware of news reports of teenagers ending up in emergency rooms or dying after participating in the 'Benadryl Challenge' encouraged in videos posted on the social media application TikTok," the agency added.

The statement said that the FDA contacted TikTok and "strongly urged them to remove the videos from their platform and to be vigilant to remove additional videos that may be posted."

Moreover, the agency recommended that parents and caregivers store these medicines "away and out of children's reach and sight."

If someone has taken too much Benadryl and is hallucinating, can't be awakened, has a seizure, has trouble breathing, or has collapsed, the FDA warns to get them medical attention immediately or contact the poison control center at: 1-800-222-1222.

At least one death has been reportedly linked to the challenge, according to local media reports in Oklahoma City, Oklahoma.

TikTok said that the hashtag for the challenge has been blocked from search on the app and has been for months, instead directing users to their Community Guidelines.

"The safety and well-being of our users is TikTok's top priority," a company spokesperson told ABC News in a statement.

"As we make clear in our Community Guidelines, we do not allow content that encourages, promotes, or glorifies dangerous challenges that might lead to injury," the spokesperson added. "Though we have not seen this content trend on our platform, we actively remove content that violates our guidelines and block related hashtags to further discourage participation. We encourage everyone to exercise caution in their behavior whether online or off."

Johnson and Johnson, the producer of Benadryl, also responded to the online challenge, saying it is "a dangerous trend and should be stopped immediately."

"Collaboration and education are critical to putting an end to this dangerous misuse," the company said, adding that it is working with TikTok and other online platforms to remove content that showcases this behavior.

"We will look to partner across industry and with key stakeholders to address this dangerous behavior," the drugmaker added.

Copyright © 2020, ABC Audio. All rights reserved.



Mumemories/iStockBy KELLY MCCARTHY, ABC News

(BERKELEY, Calif.) -- Many Americans can relate to the tempting, passing glances at the colorful assortment of confections while waiting in line at the grocery store. But one city in Northern California is making a move to help people resist the unhealthy urges at checkout in favor of healthier options.

The Berkeley City Council unanimously approved a Healthy Checkout Ordinance at its meeting on Tuesday that will be reviewed next month.

The recommendation, presented by council members Kate Harrison and Sophie Hahn who co-authored the ordinance, would require stores over 2,500-square feet to "sell more nutritious food and beverage options in their checkout areas."

"We're not saying you can't have these goods. We're just saying they're not going to be right at the eye level of your children when they walk into the store and you're waiting in that long line at check out," Harrison said, according to ABC News San Francisco station KGO.

The city is well known for its ties to the Slow Food movement -- a global nonprofit that seeks to create better food systems and help communities change the world through their relationship with clean, healthy foods. Shoppers would see the change at local stores like Safeway, CVS, Berkeley Bowl, Trader Joes and Whole Foods.

The ordinance would be adopted officially after its second reading at the City Council meeting on Oct. 13. It won’t go into effect until March 1 and enforcement won’t begin until Jan. 1, 2022.

"Today’s food landscape plays a large role in determining what people purchase and consume," the ordinance stated. "Cheap, ready-to-eat foods high in salt, saturated fat, and added sugars dominate checkout aisles, where shoppers are more likely to make impulse purchases and where parents struggle with their children over demands to buy treats at the end of a shopping trip."

Berkeley will be first in the nation to ban candy, soda at checkout aisles https://t.co/5Q2QuR9Wlv

— Berkeleyside (@berkeleyside) September 23, 2020

The city manager would determine specifics for adequate funding and staffing needs in order to implement and enforce the ordinance and sources of funding to support this program.

The ordinance laid out research and data surrounding excessive sugar and sodium intake and related disease disparities, including elevated risk of tooth decay, heart disease and Type 2 diabetes.

"The adverse health effects of added sugar consumption further entrench health disparities, burdening people of color more than white populations," the ordinance stated. "Currently, Type 2 diabetes is on the rise across the country; one in three children and one of two children of color will be diagnosed in their lifetime."

It also cited a 2019 report that found "73 percent of shoppers are concerned about the nutritional content of their food."

"The aim of placing food and beverages at checkout is to induce unplanned purchases; thus, unhealthy checkout options undermine consumers’ efforts to purchase healthier foods," according to the ordinance. "The placement of snacks near the register increases the likelihood that people purchase those foods. In addition, most of the candy, soda, and chips in checkout aisles are placed at eye-level and within reach of children, undermining parents’ efforts to feed their children well. Three-quarters of parents report that it is hard to shop at grocery stores because unhealthy food is so prevalent. Healthy checkout aisles provide all families more opportunities to say yes to their kids."

Berkeley has long been on the forefront of healthy living. It became the first city in the U.S. to pass a soda tax in 2014.

Copyright © 2020, ABC Audio. All rights reserved.



kitzcorner/iStockBy DR. L. NEDDA DASTMALCHI, ABC News

(NEW YORK) -- Prior to COVID-19, Dr. Julia Few, director of the Dartmouth-Hitchcock Moms in Recovery Program, gathered a group of women in a small room, joined together by the struggles of motherhood while battling opioid addiction. These women learned from each other, grew with each other, through an intensive three-hour session three times a week.

Now, because of the pandemic, these women have lost this important community. These sessions are hard to replicate on Zoom, and for many with unreliable internet access that's not an option anyway.

"Women with substance-use disorders, particularly in rural areas, face a lot of barriers to telehealth access," Few said. "Many of these women don't have cell reception or high-speed internet."

With the pandemic putting programs like these on hiatus, patients like Megan, who has been with Moms in Recovery, was relieved when the program started up again virtually. (She declined to give her full name for privacy reasons.)

"When groups did start going virtual, I started to feel like myself again and getting back on track," Megan said. "I am worried about the people I was close with in the program who cannot attend anymore, because it is not a question of 'if,' it's a question of 'when.'"

Secondary repercussions in health as a result of the pandemic have been profound. Three times as many people reported battling depression, and there have been more deaths from opioid overdose. Additionally, a recent peer-reviewed study found an increased susceptibility to complications from COVID-19 infection among patients struggling with substance abuse.

"I know at least one or two [people] a month who have died since July [from opioid overdose]," Megan explained. "I am just worried about the kids. The next generation all the kids will share something -- a parent who died from overdose."

Group visits for treating substance abuse and mental health disorders is not a novel idea. These programs, by creating a common bond and sense of unity, can help heal patients facing similar physical and emotional struggles.

Dr. Chanel Heermann, the director and an integrative psychiatrist at SynerGenius Telepresence and an assistant professor of psychiatry at the University of Colorado School of Medicine, finds that in-person group therapy can be helpful for many people who suffer from mental illnesses, especially among patients who battle depression and suffer from social anxiety.

"One of the great gifts that groups offer us is the realization that we have so much more in common as human beings who suffer than the diagnostic or demographic differences that divide us," she said. "That realization -- of not being alone -- can be profoundly healing."

Tawny Jones, an administrator at the Cleveland Clinic Center for Functional Medicine, said that chronic diseases don't occur in isolation. About 1 in 4 people have chronic diseases driven by modifiable lifestyle factors, including nutrition, physical activity and substance abuse. As a result of these "unifying" contributors to ill health, group visits are an excellent alternative to traditional care delivery models in dealing with chronic disease and mental health disorders.

"Group visits allow more time with practitioners to improve a patient's medical literacy and understanding of their treatment plan," Jones said. "There is also peer-to-peer sharing that can elicit information from patients that the physician may not be able to get in an individual setting, which leads to a healthy sense of pressure and motivation from peers to actively manage their condition and adhere to treatment plans."

Megan said she feels privileged to have the ability to continue her therapy virtually via Moms in Recovery, but experts have said they fear for those without similar digital access.

Dr. Andrew Myers, director of the Cleveland Clinic Community Care, agreed that the reliance on telemedicine and virtual care has led to an increase in the health care access disparities.

"Not all patients have the technical expertise or logistical support needed to fully utilize virtual care," Myers said. "The growing reliance on virtual care during this pandemic has heightened the impact of this divide."

Moms in Recovery and the Cleveland Clinic have made salient efforts to help alleviate this.

"We are actively working with community partners to mitigate this divide by extending broadband access into some of the underserved neighborhoods around our campuses," Myers explained. "More work is underway to further mitigate this divide."

Even for those with access to telemedicine, many chronic conditions, such as depression, still are better treated with in-person care, Heermann noted.

"I do believe that physical touch is critical for helping people recover from depression," she said. "For patients who live alone, those who are single, those without children or other nearby family, this can be a real concern, especially during this difficult period."

Copyright © 2020, ABC Audio. All rights reserved.



bymuratdeniz/iStockBy KATIE KINDELAN, ABC News

(NEW YORK) -- After struggling for years with disordered eating and more recently a severe eating disorder, Kwolanne Dina Felix, a college junior in New York City, realized early this year that the eating disorder had taken over her life and she was ready to seek recovery.

Then, the coronavirus pandemic hit the United States and, like so many others with eating disorders, Felix saw her condition spiral out of control.

"I tried to go into the pandemic with a sense of recovery, but that wasn't really the case," she told ABC News' Good Morning America. "Eating disorders are about routine and control and I was in a place where I was completely out of control."

"When the world is spiraling out of control, I felt like the only control I had was whether to not eat ice cream," Felix explained. "I found myself being a lot more restrictive ... I really doubled down on my habits."

Felix, 21, said the stay-at-home orders and strict social distancing brought on by the pandemic also stripped her of the social support that may have helped her eating disorder recovery in more normal times.

Stuck in isolation in New York City, she described having a "crippling fear" about weight gain, brought on in part by the "COVID 15" and "COVID 19" weight gain memes that circulated on social media.

"The 'COVID 15' was such widespread hysteria," Felix said. "I had to unfollow people and celebrities who were talking about that."

During the height of the pandemic, Felix said she did her best by following body positive accounts on social media and relying on virtual support through sites like The Unplug Collective, a platform that allows Black women to speak openly about mental health and body discrimination.

Social media influencer Charli D'Amelio, 16, a TikTok star, opened up about her own eating disorder during the pandemic. When she included a swipe-up link to the National Eating Disorder Association (NEDA), the association saw a 300% increase in website traffic, according to a spokesperson.

"I've always tried to use my voice when it comes to issues surrounding body image, but I've never talked about my own struggles with eating disorders," D'Amelio shared in an Instagram story earlier this month. "It's so uncomfortable to admit to even your closest friend and family, let alone the world. I've been afraid to share that i have an eating disorder, but ultimately i hope that by sharing this i can help someone else."

"I know disorders are something that so many other people are also battling behind closed doors," she added.

Throughout the coronavirus pandemic, the NEDA has reported a spike of more than 70% in the number of calls and online chat inquiries to its hotline compared to the same time period last year.

"This has been a time of heightened anxiety for everyone," NEDA's CEO Claire Mysko told GMA. "For people with eating disorders, either those who are actively struggling or those who are pursuing recovery, there's an added stressor with the pandemic."

Jillian Lampert, Ph.D., chief strategy officer of The Emily Program, a national network of eating disorder treatment centers, said the program has seen inquiries both online and by phone "fly off the charts" during the pandemic.

"We're seeing people calling now in a more acute, intense stage [of an eating disorder]," she said. "So we're seeing not only are more people calling, but more people are calling in a more crisis situation."

The nature of the pandemic, with its uncertainty and isolation, makes it one that "checks every box" for putting people at a higher risk for eating disorders, according to Lampert.

Mysko points to the isolating nature of the pandemic -- which has forced people to stay home and forced eating disorder treatments to go virtual -- as a particularly damaging element.

"We know that eating disorders strive with isolation," she said. "The public health guidelines with social distancing really stand in contrast to what we learn in recovery, which is all about connection and standing outside of that isolation."

In addition to isolation, the pandemic has brought on issues of food insecurity and fears for people, a disruption from norms and routines, stress related to job and financial woes and social pressure to reinvent one's self during quarantine, all of which can be contributing factors to eating disorders, experts say.

The pandemic has also brought on a mental health crisis in the U.S., of which eating disorders are a major part, according to Mysko.

"Eating disorders are very complex mental health issues with a strong relation to anxiety, depression, past histories of trauma and substance abuse," she said. "We really need to talk about them as part of this mental health crisis."

Felix -- who sought in-person treatment once New York City began to reopen -- said she learned firsthand during the pandemic that her eating disorder was a mental health concern, one that was taking over her life.

"When people talk about eating disorders, they talk about it like it's a diet," said Felix. "It's like, no, eating disorders have [one of] the highest mortality rates of any mental health disorder."

Eating disorders are second only to opioid overdose as the deadliest mental illness, with eating disorders responsible for one death every 52 minutes in the United States, according to data shared by the National Association of Anorexia Nervosa and Associated Disorders.

Eating disorders are treatable, especially if treatment is sought early, which is why, despite the alarming spike in inquiries, Mysko is glad to see so many people reaching out for help.

"We often hear from people who have waited a very long time [to seek help] because they don't feel their experience is validated or it doesn't fit into the stereotypical narrative," she said. "If you've never been in treatment or never reached out for help, that can be scary."

"We want to stress that there is help out there. There are options. There is support," added Mysko. "Recovery is not canceled."

If you or someone you know is battling an eating disorder, contact the National Eating Disorders Association (NEDA) at 1-800-931-2237 or NationalEatingDisorders.org.

Copyright © 2020, ABC Audio. All rights reserved.



frantic00/iStockBy ANGELINE JANE BERNABE, ABC News

(NEW YORK) -- When Tavi Kaunitz and Tom Lerner had to postpone their May wedding due to the coronavirus pandemic, it was stressful and upsetting for the couple, who had spent nearly a year planning their dream ceremony.

"We'd already been in the throes of planning, and you just get excited for it," Lerner told ABC News' Good Morning America. "That time was really tough and stressful."

Kaunitz and Lerner, from California, are one of many couples from all across the country who were planning on getting married in 2020, but instead quickly had to pivot, decide on a new date and rethink what their celebrations would look like.

"There was a lot of disappointment and a lot of fear about what their new wedding was going to look like," said wedding planner Victoria Holland, founder and CEO of Victoria Ann Events in Los Angeles, who worked with Kaunitz and Lerner. "For my weddings that were in May, I told them they needed to make a decision sooner than later because we needed to come up with a plan B. I think the best thing was [for us] that we were at the first line of defense right away."

The couple rescheduled for April 2021.

Event planners Neha Shah and Amanda Mendez of Blue Lotus Insights in Orange County, California, took a similar approach by creating multiple backup plans for their couples with bigger weddings.

Shah had a list of several alternative options for couples to cut down on guest lists or pivot to an outdoor wedding versus an indoor one.

While most of their couples postponed their weddings until next year, Holland, Shah and Mendez are all starting to pick up planning again with their clients, as 2021 is just around the corner. Unfortunately, with the timing of a COVID-19 vaccine still in flux, couples still have many questions.

Wedding planners are being asked by their clients how the wedding industry is going to look in 2021, but "unfortunately we know as much as anybody else does at this point that we don't know what's going to happen," Shah said.

Shah's main piece of advice for couples planning a wedding is to prepare for any roadblocks that could happen due to COVID-19.

To help other couples who have postponed their wedding to next year, Shah, Mendez and Holland all shared their top tips on what to consider when planning their special day.

Here are their top 10 pieces of advice for couples who have postponed their weddings to 2021:

1. Check to see if events are being rescheduled near your venue

Holland's first piece of advice for couples who have postponed their weddings to next year is to see when events in the city you're having your wedding have been rescheduled to. Check the city's visitor bureau to get an idea, she suggested.

"A lot of couples here in Los Angeles get married in Palm Springs," said Holland. "You definitely don't want to pick Coachella weekend for your wedding or Stagecoach weekend for your wedding because a lot of hotels are completely booked and restaurants [too]."

2. Research your local ordinances

For couples who have opted for a smaller wedding in 2021 and are having the event in their backyard, Shah suggests taking a look at your local ordinances. Different counties have their own set of rules and regulations and some counties might be more relaxed or strict than others when it comes to loud music, gatherings and more.

"If you know your local ordinances, and then are able to move around those ordinances within different counties, that can also be really helpful," she said. "With that comes safety tips. Those counties will recommend what the minimum and maximum safety tips are, which will help you navigate your wedding day itself."

3. Ask your vendors for referrals

One of the big things couples are experiencing after they've postponed their weddings is having to pick out new vendors, so Holland suggests couples ask vendors if they have any friends or people they know that they can refer you to.

"If you're looking for a photographer and your original was this beautiful, light and air, and you're looking for another one that can do that same style, ask [your photographer] them if they have any referrals," said Holland.

4. Ask your vendors about their deposit policy -- and negotiate

Planning a wedding is stressful, and one of the things that can be daunting for couples to do is putting deposits down for a wedding that may or may not happen next year amid the ongoing pandemic.

"We understand very intimately that it's money that's being put down and you don't know if that money will come to fruition or those services will come to fruition because we don't know what 2021 is going to look like," said Shah.

Ask what the deposit, postponement, cancellation and refund policies are for all your vendors. According to Shah, many vendors are agreeing to smaller deposit amounts because they also understand the uncertainty of planning a wedding during these times.

5. Read over contracts with your vendors

Holland suggests thoroughly reading contracts for each of your vendors and make sure all dates match on each contract to avoid any mixups from happening.

"Read all the addendums that are in the contracts because sometimes there's things that you might not really want to agree to," she said. "Once you sign on that dotted line, you're locked in."

6. Safety first! Sanitizing stations, matching masks and more

Now more than ever, it's so important to stay safe. Mendez suggests that guests wear masks at next year's wedding celebrations and hand sanitizing stations are made available for them throughout the venue. One way to make this stylish is to custom-make hand sanitizing bottles that fit with your decorations and even custom-make face masks for your guests.

"This is the time that we're living in right now, so you got to make the best of it," she said.

Another addition that Shah suggests couples consider for their weddings next year is to have a COVID compliance officer. Many film productions in Southern California have designated a COVID compliance officer who will do a quick assessment of guests and perform temperature checks before they enter the event.

7. Ask your guests to take COVID tests

While it may feel strange to ask guests to take COVID tests before attending your wedding, Holland said it's not an odd question to ask.

"Don't feel funny about asking your guests to get COVID tested," said Holland. "Depending on what your situation is, you can try to take some of the costs of a COVID test. You want your wedding to be enjoyable and the best way for it to be enjoyable is to know that everyone is healthy."

8. Think of new ways to serve food

How to serve food in a safe but celebratory way is one of the things at the top of wedding planners and caterers' lists. With buffet and family-style meals in limbo, Holland has seen caterers use covers for food that go with the decor, individualized hors d'oeuvres and pre-made drinks where there are less hands on the food or drinks that are being picked up.

9. Create smaller guest lists in case you need to scale down

Although couples are considering smaller weddings with a limited guest list these days, it can be tough for couples whose cultures celebrate the occasion with people beyond their immediate families. So, if the time comes that your wedding needs to shift to a smaller event, Shah suggests that you prepare smaller guest lists.

"Let's come up with 25, 50, 75, 100 person guest lists. Specifically, when it comes to saying only 25 people and then scrambling to cut people makes it a little harder," said Shah.

10. Take a deep breath

While this time can be stressful, Holland is reminding couples to take a deep breath.

"Don't get yourself crazy about what you originally thought your day was going to look like," she said. "Enjoy the engagement portion, which a lot of people don't get to do because they get right into wedding planning."

Copyright © 2020, ABC Audio. All rights reserved.



matimix/iStockBy LAURA ROMERO, ABC News

(NEW YORK) -- Every morning, before making breakfast, Chris Tyndorf looks at a sign on the kitchen wall that has become his family's motto: "God, Family, Football."

For more than 10 years, Tyndorf’s 14-year-old son has been playing football and during that time family vacations and work schedules have revolved around daily practice, weight and agility training, and games on the weekend. But as businesses and facilities began to close down as coronavirus ravaged his home state of New York in late March, football practice, a sacred family routine for Tyndorf’s son, came to a screeching halt. As the state of New York began to reopen in late July, football remained sidelined, deemed too risky by health officials.

But now, with the fall season approaching, Tyndorf, along with other parents, is objecting. He said he's preparing a lawsuit against New York State and the governing athletic association to allow fall football.

"I got tired so I decided to do something about it," Tyndorf told ABC News.

Should Tyndorf go ahead with the suit, he wouldn't be the first. At least a handful of similar suits over youth sports reportedly have been filed already in different areas of the country. The legal efforts follow the #letthemplay hashtag parents coined and which has spread as a popular rallying cry for parents and students eager to play sports during the fall.

Legal experts told ABC News the debate is likely only to get louder, and come with more lawsuits, as the fall athletic season begins with some football fields, baseball diamonds and hockey rinks empty.

Amid the pandemic, sports -- especially organized team sports with players in close contact -- could present a serious risk of coronavirus transmission, according to medical experts. But for many American parents like Tyndorf, youth sports have become a central focus of weekend free time, a building block of social interaction, and, in some cases, a path to college or the embodiment of even bigger dreams.

"We know we are not alone," said Tyndorf. "Families all over the country are fighting to get our kids back out there."

The state of New York did not respond to a request for comment for this report, and the New York State Public High School Athletic Association declined to comment. State guidance said football practices could start next week, but still no games are allowed.

Dr. Robert Glatter, an emergency physician at Lenox Hill Hospital in New York, told ABC News that he thought organized group sports are "problematic at best" -- at least until a viable vaccine is available.

"While students gain significant health benefits from playing group sports, they also constitute a chain of transmission that places all athletes, coaches, family and friends at risk for COVID-19," Glatter said. "The bottom line is this: we need to wait until an effective vaccine is widely available before we can safely allow organized sports at all levels of competition to go forward. One death is too many."

With the coronavirus pandemic still widespread and a death toll topping 200,000, parents are being forced to weigh the value of the sports for their children and themselves against the new health risks they could pose. For some, the choice has not been an easy one.

"I did not want to go through this process," said Paul Berry III, a father of a high school senior athlete who filed a lawsuit last Thursday in Missouri to overturn St. Louis County's restrictions on youth sports. The lawsuit filed by Berry claims that because of the restrictions in place, athletes, especially those of color, will be at a disadvantage to obtain scholarship and grant money.

"These restrictions are putting athletes of color in a horrible position for them to get scholarships," Berry told ABC News. "Their performance during their junior and senior year is vital. I'm definitely in support of health and safety but there's been a failure of our leadership and our kid's futures are being affected by these decisions."

"We can keep coronavirus under control," added Berry. "With the right regulations, student-athletes can go back to being part of a team and being happy."

Nadav Shoked, a professor of law at Northwestern University School of Law, said he expects to see more lawsuits and added that he's been "somewhat surprised" over the success of similar suits brought by churches and gyms against local coronavirus restrictions.

The federal Centers for Disease Control and Prevention offers detailed "guiding principles" for youth sports organizations who decide to go ahead with practices and games -- like considering the "physical closeness of players" and outbreaks in the local area when assessing risk. But if permitted by state or local coronavirus restrictions, which can vary from state to state and sport to sport, the decision to go forward falls to the organizations or school districts themselves. The result has been a patchwork of policies affecting children and parents across the nation.

Dr. Jay Bhatt, an ABC News contributor and former chief medical officer of the American Hospital Association, said he was worried about the risks that some sports pose.

"Sports that allow for individual participation and distancing like golf, tennis, or running are going to be less risky than sports that involve a lot of close contact like basketball, football, and soccer," said Bhatt. "Postponing a sporting event can be a difficult thing but has to be done to keep people safe."

Glatter, the Lennox Hill physician, added that many schools don't have the resources that professional leagues do to take precautions like daily testing and facilities that allow for outsized social distancing.

"The majority of middle and high school sports programs aren't financially or operationally able to perform frequent rapid COVID testing to assure the safety of students participating in such programs," Glatter told ABC News. "This places teachers and all family members at elevated risk for not only acquiring COVID-19 but transmitting it to others in the community."

Jeremi Duru, a law professor at American University Washington College of Law, said he was not surprised by the lawsuits that have been filed and he, too, expects more to come, considering how "politicized the threat posed by the coronavirus" has become.

"Even without a declared state of emergency, authority to order quarantine or, in this case, restrict public gatherings like youth sporting events generally exists and if a governor declares a formal state of emergency on health grounds, that authority exists too," Duru told ABC News. "But the authority requires that the restriction be rooted in something tangible – that there exists a need for the restriction. And that is where the rubber meets the road with these lawsuits. Those who are suing are essentially arguing the threat is not great enough to justify the state's use of its authority to restrict activity."

In Ohio, Tom Sunderman, the president of the Southwest Ohio Basketball, joined local sports complexes to file a lawsuit against the state department of health and the Warren County Health District in June. Two months later, they were granted a preliminary injunction, which allowed the league to resume, for now.

"We were able to show that we could open up basketball in a safe way," said Sunderman. "We are following social distancing guidelines and we have implemented temperature checks and the entire facility gets sanitized every night."

"Our kids are happy and everyone is safe," Sunderman added.

Copyright © 2020, ABC Audio. All rights reserved.



JPecha/iStockBy MINA KAJI and AMANDA MAILE, ABC News

(HELSINKI) -- They say you can't teach an old dog new tricks, but trainers in Finland claim 8-year-old greyhound mix Kössi learned to identify a scent associated with COVID-19 in just seven minutes.

Helsinki Airport welcomed Kössi and nine other "coronavirus-sniffing dogs" as part of a pilot program this week meant to "speed up the process of identifying those infected with COVID-19."

"We are among the pioneers," Helsniki Airport director Ulla Lettijeff said. "As far as we know, no other airport has attempted to use canine scent detection on such a large scale against COVID-19."

Four dogs will work at the airport during a shift, but passengers getting tested will not have direct contact with the dogs.

They will be prompted to swipe their skin with a wipe and drop it into a cup, which is then given to the dog to smell.

"The service is mainly intended for passengers arriving from outside the country," Susanna Paavilainen, CEO of WiseNose Ry, University of Helsinki's DogRisk research, explained.

The airport said that according to preliminary tests conducted by a research group at the Faculty of Veterinary Medicine at the University of Helsinki, "dogs are able to smell the virus with almost 100% certainty."

In the U.S., testing is still underway to determine if dogs can truly sniff out the coronavirus. The University of Pennsylvania's School of Veterinary Medicine (Penn Vet) launched a pilot study in April that would take a group of dogs and expose them to COVID-19-positive saliva and urine samples in a laboratory setting.

Once the dogs learned the odor, investigators would then see whether or not the animals can discriminate between COVID-19 positive and negative samples in a lab setting, according to Penn Vet.

While the results of the study have not yet been released, Penn Vet called it "pioneering" saying it "sets the stage for dogs to be a force multiplier in the mission to detect COVID-19, particularly among asymptomatic patients, or hospital or business environments where testing is most challenging."

Both the Transportation Security Administration (TSA) and U.S. Customs and Border Protection (CBP) told ABC News they are not training their canines to detect COVID-19.

Copyright © 2020, ABC Audio. All rights reserved.



ajcespedes/iStockBy KELLY MCCARTHY, ABC News

(NEW YORK) -- As people prepare to dig into their favorite Halloween candy, there's one treat with a new consumption warning for adults.

According to the U.S. Food and Drug Administration, eating black licorice in excessive amounts can prompt low potassium levels and trigger a series of irregularities and health issues.

"If you're 40 or older, eating 2 ounces of black licorice a day for at least two weeks could land you in the hospital with an irregular heart rhythm or arrhythmia," the FDA said in a statement about the candy that contains glycyrrhizin (glycyrrhizic acid) -- the sweetening compound derived from licorice root.

Alexandra Lambert, D.O., M.P.H., an ABC News Medical Unit contributor, explained that the compound can be found in other candies and supplements, but it's most commonly seen in the old-school candy with a distinct anise aroma.

"This case may be an extreme example of the deleterious effects of black licorice as there are not many other cases in the literature," Lambert added.

"Not all licorice-flavored foods contain this compound," she said. "Glycyrrhizin can cause low potassium levels in the body which can lead to abnormal heart rhythms, high blood pressure, swelling, lethargy and congestive heart failure in some people."

In some cases, Lambert added, abnormal heart rhythms could be fatal.

While many products with licorice don't disclose how much of it is contained per ounce, the FDA regulates that soft candy can only contain up to 3.1% glycyrrhizic acid.

Black licorice can "interact with some medications, herbs and dietary supplements," Lambert continued. "Experts believe that potassium levels usually return to normal without causing permanent health problems when consumption of black licorice stops."

According to the National Institutes of Health, the root of the low-growing shurb that's native to South Africa has a "long history of use as a folk or traditional remedy in both Eastern and Western medicine."

Although the NIH cites some cases of use for treatment of heartburn, stomach ulcers, bronchitis, sore throat, cough and some infections caused by viruses, the agency said, "there are insufficient data available to determine if licorice is effective in treating any medical condition."

For big black licorice fans, the FDA recommends the following advice: "No matter what your age, don't eat large amounts of black licorice at one time. If you have been eating a lot of black licorice and have an irregular heart rhythm or muscle weakness, stop eating it immediately and contact your health care provider. Black licorice can interact with some medications, herbs and dietary supplements. Consult a health care professional if you have questions about possible interactions with a drug or supplement you take."

Copyright © 2020, ABC Audio. All rights reserved.



Courtney IlarrazaBy GENEVIEVE SHAW BROWN, ABC News

(NEW YORK) -- When Courtney Ilarraza's minivan was totaled by a car traveling 60 mph on the three-mile trip from the beach to her home in Brooklyn, New York, her three children walked away unscathed.

Despite the intensity of the collision, the then-3-year-old in a five-point harness was just fine.

"I remember buckling her in and she was saying the straps were too tight," Ilarraza told Good Morning America. "But I told her that's how it was supposed to be."

This week is Child Passenger Safety Week, which focuses on the proper use of car safety seats for children.

Ilarraza, who runs Baby Bodyguards, a baby-proofing company that also offers clinics and private sessions on proper installation of car seats, told GMA that the car seat itself is less important than how it's installed. She is also a certified passenger safety technician.

"All car seats manufactured in the U.S. are held to the same crash-test standards," she said. "The difference is the bells and whistles, some of which have to do with the ease of installation." For example, the Britax Click Tight has a light that turns green when the seat is installed properly. "It's super user friendly," she said.

"Someone like me can get a less expensive seat because I know how to thread the straps and how to install it properly," Ilarraza told GMA. But when she makes recommendations, she said, she does advise parents to buy the seats that make it crystal clear they've been installed properly."

"Installation is crucial," she said. "Say you get your car seat professionally installed the first time it goes in the car, but then your kids throws up in it and you need to remove it to clean it. You want a seat that anyone can put back in the car correctly and safely."

Technology has come a long way, she said.

The American Academy of Pediatrics changed its car seat recommendations in 2018 to keep children in rear-facing seats as long as possible. It had previously suggested rear-facing until the age of 2.

"It's based on size rather than age," Ilarraza said. "And that varies between each manufacturer."

As for specific car seat recommendations, Ilarraza said the Britax Click Tight, the Uppababy Mesa and the Graco 4ever all-in-one are all easy to install. Once the child is in the seat, it's important the chest piece goes across the nipple line. "It's the perfect position to absorb impact," she said.

Finally, never use a second-hand seat, Ilarraza advised. "You don't know the history of the seat," she said, and "any seat involved in a car accident needs to be discarded and replaced."

More expert tips from Alisa Baer, known as The Car Seat Lady:


"In my 22 years experience helping parents install more than 15,000 car seats, the most common mistakes I see are 'loose and lose,' the car seat is installed too loosely in the car, and the harness straps are too loose on the child's body," Baer told "GMA." She sent her top three tips for safe car seat installation.

1. Installation: My inside/outside technique can help parents achieve a tighter installation with the majority of car seats on the market -- both rear and forward-facing. And, using the vehicle seat back recline trick in combination with the inside/outside technique can provide additional help getting the car seat tight with less of a workout required.

2. Harnessing (which is installing the child in the seat...):
When buckling a child, parents often don't realize that moving the chest clip up to armpit level is the final step, and that while tightening the straps you want to keep the chest clip low, and pull upwards on the chest straps to gather the slack and then pull the tail to remove the slack.

3. Tethers:
Every forward-facing car seat -- where the child uses a five-point harness as their restraint -- has a tether strap that secures the top of the car seat to an anchor in the back of the vehicle. Every forward-facing car seat is safer when the tether is used. Regardless of whether the forward-facing car seat is installed with the lower anchors (LATCH) or seat belt, always use the tether. Tethers decrease how far forward the child's head moves in a crash by at least 4-6 inches, which greatly reduces the risk of brain and spinal cord injury. Not sure where the tether anchors are in your vehicle? Check here!


Copyright © 2020, ABC Audio. All rights reserved.



martin-dm/iStockBy SASHA PEZENIK, ABC News

(NEW YORK) -- Before the COVID-19 pandemic pushed systemic inequalities and unprecedented stress levels to a breaking point, a crisis in American mental health already loomed.

New data released by the Centers for Disease Control and Prevention's National Center for Health Statistics surveying nearly 32,000 adults and 6,800 children across more than 33,000 households reveals that in 2019 women were more likely to experience symptoms of depression and anxiety than men, and more likely to receive counseling or therapy, or take prescription medication, to promote their mental health.

While white and Black adults reported experiencing symptoms of depression equally, white adults were more likely to receive concurrent mental health treatment. Hispanic adults were the least likely to have received any mental health treatment.

"It's a definite disparity we noticed," Emily Terlizzi, study co-author and health statistician at the NCHS, told ABC News. "These are good pre-COVID benchmarks, and we want to look now and see, do they change in 2020?"

Who needs help -- and who is getting it -- has become even more imperative during a global health emergency. Experts say the solution must first address a structural imbalance in who feels they have the right to ask for support.

"Even outside of the pandemic, women seem to be uniquely vulnerable to depression," said Dr. Pooja Lakshmin, a clinical assistant professor of psychiatry at George Washington University School of Medicine who specializes in women's mental health. "I think there's more permission for women to say, 'Hey, I need help.' That framework exists for women in a way where for men it's much harder to do that. But at the same time, there are still gaps in our mental health system."

Black and Brown communities especially have faced a centuries-long climb toward health equity, experts say.

"You're not supposed to tell strangers your secrets," Alysha Pamphile, 34, a Haitian American video producer based in New Jersey, told ABC News. "There's such a taboo around therapy, and the space of being vulnerable, a sense of weakness, when in fact, it's quite the opposite. But we weren't given the language to do that; we hadn't been allowed that grace."

"The root structure of psychology, and much of what's been baked into even the foundations of mental health, has been stigmatizing and not at all supportive in meeting the needs of communities of color. Beyond that, it is just a very foreign concept," Dr. Joy Harden Bradford, a clinical psychologist based in Atlanta, told ABC News.

She founded "Therapy for Black Girls," a blog meant to make space for Black women to talk about their mental health.

"We convince ourselves we're supposed to be unbreakable even if we're hurting," Bradford said. "So we need to instill that it's OK to not be OK for communities of color -- but even more importantly, to realize when that's so and actively seek support."

Normalizing mental health treatment and availing it to those in need begins with fleshing out an emotional lexicon for groups that have long been left out of the conversation, experts say. Women may be more likely to experience symptoms of depression, but they also may be more likely to admit it. A Black man may not feel equipped to ask for help, even if he feels the need.

"What existed pre-COVID, and certainly exists now, is still tremendous cultural mistrust, on behalf of not just African Americans, but other racially ethnically marginalized people," Dr. Rheeda Walker, professor of psychology at the University of Houston and author of The Unapologetic Guide to Black Mental Health, told ABC News.

"And the way that we assess depression could allow us to miss depression -- in men, for example," Walker said. "And then also, men tend not to use emotional words as much as women do or disclose how they're feeling."

And symptoms can present uniquely: psychosomatic pain can be the body's sly way of indexing emotions we don't feel comfortable feeling.

"Anxiety could show up as a headache or a stomach ache, and you don't necessarily connect it to mental health," Bradford said. "We don't want to show the world we're weak, so that means that we can even have a hard time recognizing for ourselves when we have reached a breaking point."

Now amid a global crisis mode, there is further stress on the groups most vulnerable to the virus itself, most vulnerable to its socioeconomic impact and yet least likely to receive mental health support.

"Pre-COVID, we've already seen nationally increasing anxiety, people feeling overwhelmed, people hurting," Walker said. "Coronavirus kind of puts all of that on steroids because of the level of disruption."

What COVID-19's ravages have compelled, experts say, is more candid confrontation of social injustice and mental health disparities.

"Parallel to this pandemic has been this racial awakening, and I think now we're forced to stare it down," Pamphile said. "And I was forced to meet myself. It's been a beautiful as well as a traumatic experience. Now that we're forced to sit between our four walls, where there's nothing but mirrors -- on top of looking at the world wide web, social media, where we're seeing ourselves be murdered -- we have no choice but to start understanding that help is OK."

"This is not new human suffering, but now the importance of mental health in these contexts has been brought to people's attention in a way I haven't seen before," Lakshmin said. "What remains to be seen is whether we develop the resources to meet that need."

Copyright © 2020, ABC Audio. All rights reserved.



smolaw11/iStockBy SOPHIE TATUM, ABC News

(NEW YORK) -- As concern grows among researchers about the extent to which the novel coronavirus might be transmitted through the air, advocates and educators said they have long been concerned about poor air circulation due to outdated ventilation systems.

In June, Terrie Brady, president of Duval Teachers United, walked through the halls of some of the schools in her Florida community, and said she saw "dirt hanging out of the air ducts."

"It was just filthy. So, if you have dirty air vents or air ducts in classrooms, you know that they haven't been cleaned," Brady told ABC News.

"It was an issue before COVID, but I think it's heightened under COVID," said Andrew Spar, president of the Florida Education Association.

A group that represents educators in Texas has been surveying members across the state regarding concerns related to COVID-19 safety procedures. Clay Robison of the Texas State Teachers Association said that as of Monday, the second-highest number of COVID-19-related complaints were for inadequate ventilation or ventilation equipment, behind complaints that schools did not make appropriate accommodations for high-risk employees.

"The inadequate ventilation or ventilation equipment part was cited 477 times out 788 respondents," Ovidia Molina, Texas State Teachers Association president, told ABC News in a phone interview.

"So, it's a really big concern. It's not just the complaints about having dirty filters that school districts can change out as soon as they've been told. But it's the sort of feeling of, you know, waiting until it's a problem to fix it," she said.

Molina said school districts in the state don't have the money to keep up with the changes that need to happen.

"We know that the ventilation systems are very expensive and they're one of the last things to be fixed. You know, pretty much until they get broken," Molina said.

Brady said Duval County, Florida, has some of the oldest schools in the state -- some buildings are 50 years or older. She said most of the air conditioning units are "so outdated and antiquated," that, "even if we wanted to get the specialized air filters that they have now to combat some of the particles, they won't even fit in our units and our handlers."

Brady said the group has pushed for the district to continuously clean out air ducts and air filters, but Brady said it is "absolutely" a concern for her district, noting that some teachers along with parents have purchased air purifying machines for their classrooms.

"Air purification is a big deal. And the thing is, is that's probably one of your most expensive expenditures you could possibly have," Brady said.

In June, a report released by the Government Accountability Office found that about half of public schools in the United States need to update or replace building systems, including about 36,000 school buildings that need updated heating, ventilation and air conditioning systems.

The report raised alarm bells at the time from House Education and Labor committee Chairman Bobby Scott, D-Va., who said, "Even before the COVID-19 pandemic, outdated and hazardous school buildings were undermining the quality of public education and putting students and educators at risk."

"Now, the pandemic is exacerbating the consequences of our failure to make necessary investments in school infrastructure," he said.

On Tuesday, White House Coronavirus Task Force member Dr. Anthony Fauci said it's a reasonable assumption that there is some aerosol transmission of the virus -- raising more questions about virus transmission in the classroom.

The Centers for Disease Control and Prevention's guidance for safely reopening schools also advises ensuring that ventilation works properly, in addition to increasing outdoor air circulation when possible, by doing things like opening windows and doors.

However, Spar said that it's not as easy as just opening windows, either -- especially in Florida where it can get over 90 degrees.

"Just a week or two ago, we were had heat indexes of over 100 degrees," Spar said. "So, you know, opening a window or being outside is certainly not something that was advisable."

Because of this, Spar said schools rely on air conditioning units.

"And you hope that the air conditioning units have adequate filtration, that they're using high-quality filters. But unfortunately, in districts where money is tight, that's not always the case," he said.

Copyright © 2020, ABC Audio. All rights reserved.